EP0497079B1 - Kniegelenkprothese - Google Patents
Kniegelenkprothese Download PDFInfo
- Publication number
- EP0497079B1 EP0497079B1 EP91810973A EP91810973A EP0497079B1 EP 0497079 B1 EP0497079 B1 EP 0497079B1 EP 91810973 A EP91810973 A EP 91810973A EP 91810973 A EP91810973 A EP 91810973A EP 0497079 B1 EP0497079 B1 EP 0497079B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- knee joint
- joint prosthesis
- femur
- intermediate part
- prosthesis according
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3868—Joints for elbows or knees with sliding tibial bearing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30016—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in hardness, e.g. Vickers, Shore, Brinell
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2002/30733—Inserts placed into an endoprosthetic cavity, e.g. for modifying a material property
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0019—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in hardness, e.g. Vickers, Shore, Brinell
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
Definitions
- the invention relates to a knee joint prosthesis with a femur part
- the double convex, condyle-like wings in the anterior / posterior direction are formed from at least two circular sectors with different radii and center points and each have a single curvature in the medial / lateral direction, the radius of which corresponds to the larger radius
- Anterior / posterior curvature corresponds, as well as with a tibia part, in which there is an intermediate part made of plastic between a metal tibia plateau that can be anchored in the tibia and the femur part, the surface of which faces the femur has double-concave curved bearing surfaces for the femur condyles.
- Knee joint prostheses of the type described above are widely known; as examples, reference is made to CH-A-674 798 or EP-B-0 021 421 (Büchel / Pappas meniscus knee) from the patent family of US-A-4,340,978. With these prostheses, practice has now shown that the intermediate parts suffer an inadmissibly high abrasion over time, the particles of which lead to undesirable inclusions in the living tissue surrounding the joint and thus to disorders and damage.
- the object of the invention is to reduce or largely avoid abrasion in the plastic intermediate part. This goal is achieved by the features of independent claim 1.
- the bearing surfaces of an intermediate part are provided with a number of supports which act as abrasion-reducing bearing surfaces for the femur part.
- their support surfaces are complementarily matched to the doubly convex bearing surfaces of the femoral part, i.e. also designed as cutouts of double concave curved surfaces.
- the support surfaces In order to achieve the largest possible force absorption of the support surfaces of the hard support bodies, both with the knee extended and flexed, the support surfaces have two different concave curvatures, the radii of which correspond to the radii of the convex anterior / posterior curvatures of the femoral condyles, preferably the edge regions of the support surfaces have a radius corresponding to the larger radius of the condyles and the central regions have a radius corresponding to the smaller radius of the condyles. For manufacturing reasons, support surfaces that are cutouts from spherical surfaces are preferred.
- the support surfaces with which the support bodies are mounted in depressions in the intermediate part and / or the counter surfaces to this — ie the “bottoms” - in the depressions of the intermediate part be convex.
- the lateral surfaces of the support bodies and the complementary counter surfaces of the depressions in the intermediate part are formed as cutouts from spherical surfaces, since this leads to a certain guidance of the support body movements in the intermediate part.
- the intermediate parts may be floating on the tibial plateau; in such constructions it may be advantageous if the surface of the intermediate part facing the tibial plateau is also equipped with metal supporting bodies, the supporting surfaces of which are adapted to the shape of the interface between the tibial plateau and the intermediate part.
- the support bodies belong to at least the same material class as the femoral part, i.e. for ceramic wings of the femoral part made of ceramic and for metallic wings of the femoral part made of metal; in particular, it is possible to manufacture at least the sliding or supporting surfaces of the supporting bodies from the same material as the supporting surfaces of the femoral part.
- An intermediate part 3 is mounted on a tibial plateau 1 (FIG. 1), which can be anchored in the tibia (not shown) by means of a peg-like shaft 2, between the generally metallic tibial plateau 1 and a schematically indicated one, also mostly made of metal manufactured femoral part 4 to act as a shock-absorbing elastic element - consists of a, possibly fiber-reinforced, plastic, for example made of polyethylene (PE).
- PE polyethylene
- the support surfaces 5 of the femoral part 4 are double convex surfaces, as shown in FIG. 1 and for the complementary concave bearing surface 6 shown in FIG. 3; There is a single curvature in the medial / lateral direction for each condyle, the radius of curvature of which is designated R1, as can be seen again for the associated bearing surface 6 from FIG. 3.
- the curvature of the wings 5 of the femoral part 4 in the anterior / posterior direction is composed of two circular sectors, one of which - the one "bearing" in the illustrated standing phase of the joint - also has the radius R1; a circle sector with the smaller radius of curvature R2 adjoins the first circle sector posteriorly.
- the area of the wings 5 with the smaller radius of curvature R2 is used when the knee is bent.
- a bearing surface 6 is provided in the intermediate part 3, which represents a section of a hollow spherical surface with the radius R1.
- the intermediate part 3 is provided with a bead-like elevation 7 between the bearing surfaces 6 for the two condyles (FIG. 2).
- each of the bearing surfaces 6 there are supporting bodies 8 as supporting elements, which are inserted into recesses 9 of the intermediate part 3 in such a way that their supporting surfaces 10 lie as precisely as possible in the bearing surfaces 6.
- At least the supporting surfaces of the supporting bodies 8 consist of a material which is hard relative to the plastic of the intermediate part 3 and which at least belongs to the same material class or, preferably, is the same as that of the supporting surfaces 5 of the femoral part 4.
- the shape of the support surfaces 10, which are integrated as precisely as possible into the bearing surface 6 of the intermediate part 3, are complementarily adapted in shape to the support surfaces 5 of the femoral part 4. They are therefore designed as cutouts from spherical surfaces, the edge regions 10 '(FIGS. 2 and 4) having a radius which corresponds to the radius R1 of the anterior / posterior curvature of the condyle bearing surfaces 5 in the stance phase, while the central regions 10' '( 2 and 4) of each support surface 10 have the radius R2 of the posterior wing area. In this way, the support surfaces 10 nestle well against the wings 5 of the femoral part 4 when the knee is extended and angled, and the loads are distributed over a relatively large total area.
- both the contact surfaces 11 (FIG. 4) with which the support bodies 8 are mounted on the counter surfaces or “bottoms” 12 (FIG. 4) of the depressions 9 of the intermediate part 3, and also these counter surfaces 12 themselves are designed to be curved. So that the relative movements of the support body 8 relative to the intermediate part 3, and thus the Bearing of the support surfaces 10 on the wings 5 facilitated.
- both the lateral surfaces 13 (FIG. 4) of the support body 8 and the complementary surfaces 14 (FIG. 4) of the depressions 9 are designed as spherical or hollow spherical surfaces.
- the support bodies 8 are also made of metal in most applications, for example a cobalt-based alloy or of another alloy used for implants.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Physical Education & Sports Medicine (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Description
- Die Erfindung betrifft eine Kniegelenkprothese mit einem Femurteil, dessen doppelt konvex gekrümmte, kondylenartige Tragflächen in Richtung anterior/posterior aus mindestens zwei Kreissektoren mit unterschiedlichen Radien und Mittelpunkten gebildet sind und in Richtung medial/lateral je eine einzige Krümmung aufweisen, deren Radius dem grösseren Radius der Anterior/posterior-Krümmung entspricht, sowie mit einem Tibiateil, bei dem zwischen einem in der Tibia verankerbaren, metallenen Tibiaplateau und dem Femurteil ein Zwischenteil aus Kunststoff vorhanden ist, dessen dem Femur zugewandte Oberfläche doppelt konkav gekrümmte Lagerflächen für die Femurkondylen aufweist.
- Kniegelenkprothesen der vorstehend beschriebenen Art sind vielfach bekannt; als Beispiele wird verwiesen auf die CH-A-674 798 oder die EP-B-0 021 421 (Büchel/Pappas Meniskusknie) aus der Patentfamilie der US-A-4,340,978. Bei diesen Prothesen hat die Praxis nun gezeigt, dass die Zwischenteile im Laufe der Zeit einen unzulässig hohen Abrieb erleiden, dessen Teilchen in dem das Gelenk umgebenden lebenden Gewebe zu unerwünschten Einschlüssen und damit zu Störungen und Schädigungen führen.
- Aufgabe der Erfindung ist es, den Abrieb bei dem Kunststoff- Zwischenteil zu vermindern oder weitgehend zu vermeiden. Dieses Ziel wird durch die Kennzeichen vom unabhängigen Anspruch 1 erreicht.
- Die Lagerflächen eines Zwischenteils sind auf diese Weise mit einer Anzahl von Auflagern versehen, die als abriebsvermindernde Tragflächen für den Femurteil wirken. Um bei den Auflagern eine möglichst grosse "Belastungsfläche" zu erreichen, sind deren Stützflächen komplementär an die doppelt konvex gekrümmten Tragflächen des Femurteils angeglichen, d.h. ebenfalls als Ausschnitte doppelt konkav gekrümmter Flächen ausgebildet. Um sowohl bei gestrecktem als auch bei flexiertem Knie eine möglichst grossflächige Kraftaufnahme der Stützflächen der harten Stützkörper zu erreichen, haben die Stützflächen zwei unterschiedliche konkave Krümmungen, deren Radien den Radien der konvexen Anterior/posterior-Krümmungen der Femurkondylen entsprechen, wobei bevorzugterweise die Randbereiche der Stützflächen einen dem grösseren Radius der Kondylen und die zentralen Bereiche einen dem kleineren Radius der Kondylen entsprechenden Radius haben. Aus fabrikatorischen Gründen werden dabei Stützflächen bevorzugt, die Ausschnitte aus Kugelflächen sind.
- Um die "Einstellung" oder "Anpassung" der Stützkörper an die Tragflächen des Femurteils zu erleichtern, können die Auflageflächen, mit denen die Stützkörper in Vertiefungen des Zwischenteils gelagert sind, und/oder die Gegenflächen dazu - d.h. die "Böden" - in den Vertiefungen des Zwischenteils bombiert sein. Bei derartig bombierten Stützkörpern oder Zwischenteilen ist es zusätzlich vorteilhaft, wenn die Mantelflächen der Stützkörper und die dazu komplementären Gegenflächen der Vertiefungen im Zwischenteil als Ausschnitte aus Kugelflächen ausgebildet sind, da dadurch eine gewisse Führung der Stützkörperbewegungen im Zwischenteil erfolgt.
- In bekannter Weise können die Zwischenteile auf dem Tibiaplateau unter Umständen schwimmend gelagert sein; bei derartigen Konstruktionen ist es möglicherweise vorteilhaft, wenn die dem Tibiaplateau zugewandte Oberfläche des Zwischenteils ebenfalls mit metallenen Stützkörpern bestückt ist, deren Stützflächen an die Form der Grenzfläche zwischen Tibiaplateau und Zwischenteil angepasst ist.
- Schliesslich ist es sinnvoll, wenn die Stützkörper zumindest der gleichen Materialklasse angehören wie der Femurteil, d.h. bei keramischen Tragflächen des Femurteils aus Keramik und bei metallischen Tragflächen des Femurteils aus Metall bestehen; insbesondere ist es möglich, zumindest die Gleit- oder Stützflächen der Stützkörper aus dem gleichen Material zu fertigen wie die Tragflächen des Femurteils.
- Im folgenden wird die Erfindung anhand eines Ausführungsbeispiels im Zusammenhang mit der Zeichnung näher erläutert.
- Fig. 1
- zeigt, teilweise im Schnitt I-I von Fig. 2, eine Ansicht der neuen Kniegelenkprothese von medial oder lateral aus gesehen;
- Fig. 2
- ist eine Aufsicht auf einen Zwischenteil einer Prothese nach Fig. 1;
- Fig. 3
- gibt einen Schnitt III-III von Fig. 2 wieder, während
- Fig. 4
- in vergrössertem Massstab ein Detail aus Fig. 1 zeigt.
- Auf einem Tibiaplateau 1 (Fig. 1), das mittels eines zapfenartigen Schaftes 2 in der nicht dargestellten Tibia verankerbar ist, ist ein Zwischenteil 3 gelagert, das - um zwischen dem im allgemeinen metallenen Tibiaplateau 1 und einem nur schematisch angedeuteten, ebenfalls meist aus Metall gefertigten Femurteil 4 als stossdämpfendes elastisches Element zu wirken - aus einem, unter Umständen faserverstärkten, Kunststoff, beispielsweise aus Polyethylen (PE), besteht.
- Die Tragflächen 5 des Femurteils 4 sind doppelt konvex gekrümmte Flächen, wie aus Fig. 1 und für die dazu komplementäre konkave Lagerfläche 6 aus Fig. 3 ersichtlich; in medial/lateraler Richtung ist bei jeder Kondyle eine einzige Krümmung vorhanden, deren Krümmungsradius mit R1 bezeichnet ist, wie wieder für die zughörige Lagerfläche 6 aus Fig. 3 zu erkennen ist. Die Krümmung der Tragflächen 5 des Femurteils 4 in Richtung anterior/posterior setzt sich aus zwei Kreissektoren zusammen, von denen der eine - der in der dargestellten Standphase des Gelenkes "tragende" - ebenfalls den Radius R1 hat; an den ersten Kreissektor schliesst sich posterior ein Kreissektor mit dem kleineren Krümmungsradius R2 an. Der Bereich der Tragflächen 5 mit dem kleineren Krümmungsradius R2 kommt bei abgewinkeltem Knie zum "Einsatz".
- Für jede Femurkondyle ist im Zwischenteil 3 eine Lagerfläche 6 vorgesehen, die einen Ausschnitt aus einer Hohlkugelfläche mit dem Radius R1 darstellt. Zur seitlichen Führung des Femurteil 4 ist der Zwischenteil 3 zwischen den Lagerflächen 6 für die beiden Kondylen mit einer wulstartigen Erhöhung 7 versehen (Fig. 2).
- In jeder der Lagerflächen 6 sind als tragende Elemente Stützkörper 8 vorhanden , die in Vertiefungen 9 des Zwischenteils 3 derart eingesetzt sind, dass ihre Stützflächen 10 möglichst genau in den Lagerflächen 6 liegen. Zumindest die Stützflächen der Stützkörper 8 bestehen aus einem relativ zum Kunststoff des Zwischenteils 3 harten Material, das zumindest der gleichen Materialklasse angehört oder, vorzugsweise, das Gleiche ist wie dasjenige der Tragflächen 5 des Femurteils 4.
- Die Stützflächen 10, die möglichst exakt in die Lagerfläche 6 des Zwischenteils 3 integriert sind, sind in ihrer Form an die Tragflächen 5 des Femurteils 4 komplementär angepasst. Sie sind daher als Ausschnitte aus Kugelflächen ausgebildet, wobei die Randbereiche 10' (Fig. 2 und 4) einen Radius aufweisen, der dem Radius R1 der Anterior/posterior-Krümmung der Kondylentragflächen 5 in der Standphase entspricht, während die Zentralbereiche 10'' (Fig. 2 und 4) jeder Stützfläche 10 den Radius R2 des posterioren Tragflächenbereiches haben. Auf diese Weise schmiegen sich die Stützflächen 10 bei gestrecktem und bei abgewinkeltem Knie gut an die Tragflächen 5 des Femurteils 4 an, und die Belastungen werden über eine relativ grosse Gesamtfläche verteilt weitergeleitet.
- Sowohl die Auflageflächen 11 (Fig. 4), mit denen die Stützkörper 8 auf den Gegenflächen oder "Böden" 12 (Fig. 4) der Vertiefungen 9 des Zwischenteils 3 gelagert sind, als auch diese Gegenflächen 12 selbst sind bombiert ausgebildet. Damit werden die Relativbewegungen der Stützkörper 8 gegenüber dem Zwischenteil 3, und damit das Anliegen der Stützflächen 10 an den Tragflächen 5 erleichtert. Um diese Relativbewegungen zu führen, sind sowohl die Mantelflächen 13 (Fig. 4) der Stützkörper 8, als auch die dazu komplementären Flächen 14 (Fig. 4) der Vertiefungen 9 als Kugel- bzw. Hohlkugelflächen ausgeführt.
- Da, wie bereits erwähnt, der Femurteil 4 und seine Tragflächen 5 vorzugsweise aus Metall bestehen, sind die Stützkörper 8 in den meisten Anwendungsfällen ebenfalls aus Metall, beispielsweise einer Kobaltbasislegierung oder aus einer anderen der für Implantate gebräuchlichen Legierungen gefertigt.
Claims (10)
- Kniegelenkprothese mit einem Femurteil (4), dessen doppelt konvex gekrümmten, kondylenartigen Tragflächen (5) in Richtung anterior/posterior aus mindestens zwei Kreissektoren mit unterschiedlichen Radien (R1 und R2) und Mittelpunkten gebildet sind und in Richtung medial/lateral je eine einzige Krümmung aufweisen, deren Radius dem grösseren Radius (R1) der Anterior/posterior-Krümmung entspricht, sowie mit einem Tibiateil, bei dem zwischen einem in der Tibia verankerbaren, metallenen Tibiaplateau (1) und dem Femurteil(4) ein Zwischenteil (3) aus Kunststoff vorhanden ist, dessen dem Femur zugewandte Oberfläche doppelt konkav gekrümmte Lagerflächen (6) für die Femurkondylen aufweist, dadurch gekennzeichnet, dass in den Lagerflächen (6) des Zwischenteils (3) einzelne Stützkörper (8) aus, relativ zum Kunststoff, hartem Material verteilt sind, deren in der Lagerfläche (6) liegende Stützflächen (10) ebenfalls doppelt konkav gekrümmt sind und dass die Stützflächen (10) zwei unterschiedliche konkave Krümmungen haben, deren Radien den Radien (R1 und R2) der konvexen Anterior/posterior-Krümmungen der Femurkondylen entsprechen.
- Kniegelenkprothese nach Anspruch 1, dadurch gekennzeichnet, dass die Stützflächen (10) Ausschnitte aus Kugelflächen sind.
- Kniegelenkprothese nach Anspruch 2, dadurch gekennzeichnet, dass die Randbereiche (10') der Stützflächen (10) einen dem grösseren Radius (R1) der Kondylen und die zentralen Bereiche (10'') einen dem kleineren Radius (R2) der Kondylen entsprechenden Radius haben.
- Kniegelenkprothese nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Auflageflächen (11), über die die Stützkörper (8) in Vertiefungen (9) des Zwischenteils (3) gelagert sind, bombiert sind.
- Kniegelenkprothese nach Anspruch 4, dadurch gekennzeichnet, dass in den Vertiefungen (9) des Zwischenteils (3) die Gegenflächen (12) zu den Auflageflächen (11) der Stützkörper (8) ebenfalls bombiert sind.
- Kniegelenkprothese nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, dass der Zwischenteil (3) schwimmend auf dem Tibiaplateau (1) gelagert ist.
- Kniegelenkprothese nach Anspruch 6, dadurch gekennzeichnet, dass die dem Tibiaplateau (1) zugewandte Oberfläche des Zwischenteils (3) ebenfalls mit metallenen Stützkörpern bestückt ist, deren Stützflächen an die Form der Grenzfläche zwischen Tibiaplateau (1) und dem Zwischenteil (3) angepasst ist.
- Kniegelenkprothese einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, dass die Mantelflächen (13) der Stützkörper (8) und die dazu komplementären Flächen (14) der Vertiefungen (9) des Zwischenteils (3) als Ausschnitte aus Kugelflächen ausgebildet sind.
- Kniegelenkprothese nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Stützkörper (8) der gleichen Materialklasse angehören wie der Femurteil (4).
- Kniegelenkprothese nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass die Stützkörper (8) aus dem gleichen Material wie der Femurteil (4) bestehen.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CH144/91 | 1991-01-18 | ||
CH14491 | 1991-01-18 |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0497079A1 EP0497079A1 (de) | 1992-08-05 |
EP0497079B1 true EP0497079B1 (de) | 1996-05-15 |
Family
ID=4180257
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP91810973A Expired - Lifetime EP0497079B1 (de) | 1991-01-18 | 1991-12-13 | Kniegelenkprothese |
Country Status (5)
Country | Link |
---|---|
US (1) | US5197987A (de) |
EP (1) | EP0497079B1 (de) |
AT (1) | ATE137950T1 (de) |
DE (1) | DE59107815D1 (de) |
ES (1) | ES2086516T3 (de) |
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IT1026671B (it) * | 1974-11-29 | 1978-10-20 | Gaia Mario | Protesi sostitutiva di articolazioni ad esempio articolazione della anca con elementi di scorrimento inseriti sulle superfici a contato |
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CH632923A5 (en) * | 1978-10-06 | 1982-11-15 | Sulzer Ag | Implant for partial replacement of a sliding surface of a human joint |
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- 1991-12-13 EP EP91810973A patent/EP0497079B1/de not_active Expired - Lifetime
- 1991-12-13 AT AT91810973T patent/ATE137950T1/de not_active IP Right Cessation
- 1991-12-13 DE DE59107815T patent/DE59107815D1/de not_active Expired - Fee Related
- 1991-12-13 ES ES91810973T patent/ES2086516T3/es not_active Expired - Lifetime
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1992
- 1992-01-14 US US07/820,357 patent/US5197987A/en not_active Expired - Fee Related
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Also Published As
Publication number | Publication date |
---|---|
US5197987A (en) | 1993-03-30 |
DE59107815D1 (de) | 1996-06-20 |
EP0497079A1 (de) | 1992-08-05 |
ATE137950T1 (de) | 1996-06-15 |
ES2086516T3 (es) | 1996-07-01 |
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